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Friday, 7 September 2012

Medical Education & Social Media

This is a short review I wrote for the IDEACON conference brochure souvenir that ran in India in July. I've included it here with some corrections. Comments and flames welcomed! :-)

Medical education could benefit from new forms of communication between health professionals made possible through social media - a collection of technologies that use the Internet to connect people. These technologies will be familiar to many and include Twitter, Facebook, LinkedIn and Google+. These social media create connections between individuals and form networks within which information is shared. In this short review I will outline some of the opportunities and challenges facing the use of social media and medical education. I will not focus on any particular form of medical education so the discussion includes undergraduate and postgraduate.

Although there have always been networks and communities of physicians it has not been on a scale and immediacy that is now possible with social media. In the past the size of communities was restricted by geography and slower modes of communication. This has broadened in recent decades. For example, the use of Twitter at conferences has increased and can be "successfully used by physicians ... to engage in clinical discussions" even if the author is not present at the event [1]. Scientists see social media as a critical form of communication [2], especially with the public, but also with colleagues and experts within and outside their disciplines. Some academics have called for the career recognition of the open, digital and networked exchange of information [3]. They argue that publishing should not be seen as a restricted, academic activity within journals but as part of a more open discourse and discovery.

However, I'd argue that social media and other new technologies are here to stay and we should become familiar with them. How can they be used in medical education? How should they be used to increase our knowledge and the reach of our profession?

Recent theories of learning can be viewed as frameworks explaining how a particular type of learning takes place. Two of these learning theories I will describe further with reference to how social media can be successfully used in medical education.

Communities of Practice

Lave and Wenger's work on situated (workplace) learning has been extended to describe communities in the digital habitats [10] within which modern practitioners share the passion and expertise of their work. A Community of Practice has three dimensions of domain, practice and community. The domain is the area that participants have in common. The practice is the shared expertise that they have within that domain and the community consists of the social links between members of the Community of Practice.

The Facebook group "Key Opinion Leaders (KOL) blog on Diabetes and Endocrinology" [11] is an example of a Community of Practice of doctors, academics and the pharmaceutical industry based mainly in India. The domain is the scientific evidence in the field of diabetes and endocrinology. The practice is the critical appraisal skills and aggregation of information in the medical literature. The community is the social links between the members many of whom are based in India and discuss football and conferences alongside the discussions of new scientific findings. Facebook acts as the communication technology between members of the group allowing them to interact with each other at times that are convenient to each individual. The group has been set up and is monitored by some core individuals who perform the duties of digital stewardship - continually experimenting with and evaluating the usefulness of the technology to the needs of the group.

You are probably part of a community of practice already. Some communities have used the digital ecologies including social media but this is only useful if the community of practice finds it of value.

Connectivism describes the use of the technology available to learners today. Learners create blogs (weblogs - short public articles published on the web), post discussions on discussion boards, and stream thoughts through social media. They use tags to classify information such as #diabetes or #meded on Twitter and then others can use search engines to find postings from the network of learners interested in the same topic. The learner, in the world of connectivism, is not simply the student with inferior knowledge but everyone involved in the topic. Learners and the expertise is maintained in the network and not necessarily within the individuals.

An example of connectivism would be the use of the tag #CMEchat which involves an ongoing discussion of Continuing Medical Education (CME) by an international audience with varying levels of expertise. It ran, until recently, each week on a Wednesday at 11am EST, there is a Twitter chat where the community comes together for an hour to discuss an agenda on CME. In between the discussions individuals post to Twitter, on their own websites, in blogs, on YouTube and social bookmarking sites such as delicious.com, items of interest and insights that they tag with #CMEchat for others to find. Individuals involved learn from each other and from the collected expertise of the group. Others can engage with the topic by searching and finding the resources identified by #CMEchat or through the central hub of the group on its website (www.cmeadvocate.com). Over time the expertise in CME is increased and artefacts are developed by the participants that are available to others.

An important aspect of connectivism is its openness and, in particular, the looseness of its definition of membership or engagement.

How should a novice in this area get started? What simple steps can be suggested to 'plug in' to this new world of medical education? Some suggestions have been made by others [14,15] and I have summarised an approach below.

Start by 'lurking'. This means just listening and reading the social media that others produce. Join some social media sites, search for your areas of interest, and follow people to see what they are talking about. You don't need to post straight away so don't feel obliged to. It is generally good advice when joining any community to listen first to understand the culture and norms before talking yourself.

Rewrite your CV into a short biography of about 100 words and get a photograph of yourself so that you can use it as your profile in the social media sites that you join.

Talk to your colleagues at your institution and see what they feel about social media. Is it available on your computer network and what would be the implications if it were. Read your own specialist society's advice on social media.

When you are ready start posting - we look forward to hearing from you.

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